tumoral calcinosis during the course of systemic sclerosis · tumoral calcinosis can occur during...

348 The Journal of Rheumatology 2015; 42:2; doi:10.3899/jrheum.140335 Personal non-commercial use only. The Journal of Rheumatology Copyright © 2015. All rights reserved. Images in Rheumatology Tumoral Calcinosis During the Course of Systemic Sclerosis ALEXANDRA AUDEMARD, MD; NICOLAS MARTIN SILVA, MD; JONATHAN BOUTEMY, MD; GWENOLA MAIGNÉ, MD; BORIS BIENVENU, MD, PhD, Department of Internal Medicine, Caen University Hospital, and the Faculty of Medicine, University Caen, Caen, France. Address correspondence to Dr. A. Audemard, Department of Internal Medicine, CHU Côte de Nacre, BP 95182, 14033 Caen cedex 9, France. E-mail: [email protected]. J Rheumatol 2015;42:348; doi:10.3899/jrheum.140335 Although rare, tumoral calcinosis can occur during the course of systemic sclerosis (SSc). A 51-year-old woman was diagnosed in 2011 with limited cutaneous SSc, complicated by myositis. The main clinical manifestation was extensive calcinosis at multiple localizations (hip, finger, back, neck), leading to signifi- cantly reduced quality of life. One year later, she com- plained of left coxalgia. Computed tomography demonstrated tumoral soft tissue calcification surrounding the left hip joint (Figure 1). Ectopic soft tissue calcinosis is frequent (i.e., 25%) in limited SSc. Lesions are commonly located in pressure areas, most frequently in the hands. Calcinosis presumably occurs in tissues damaged by mechanical stress, hypovascularity, and tissue hypoxia 1 . Tumoral calcinosis can occur during the course of SSc, but is very rare. Treatments with warfarin, colchicine, bisphosphonate, diltiazem, minocycline, and surgical excision have been reported, but none have shown significant efficacy 1,2,3 . REFERENCES 1. Boulman N, Slobodin G, Rozenbaum M, Rosner I. Calcinosis in rheumatic diseases. Semin Arthritis Rheum 2005;34:805-12. 2. Sultan-Bichat N, Menard J, Perceau G, Staerman F, Bernard P, Reguiaï Z. Treatment of calcinosis cutis by extracorporeal shock-wave lithotripsy. J Am Acad Dermatol 2012;66:424-9. 3. Saddic N, Miller JJ, Miller OF 3rd, Clarke JT. Surgical debridement of painful fingertip calcinosis cutis in CREST syndrome. Arch Dermatol 2009;145:212-3. Figure 1. Computed tomography demonstrated tumoral soft tissue calcification surrounding the left hip joint. www.jrheum.org Downloaded on April 2, 2021 from

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348 The Journal of Rheumatology 2015; 42:2; doi:10.3899/jrheum.140335

Personal non-commercial use only. The Journal of Rheumatology Copyright © 2015. All rights reserved.

Images in Rheumatology

Tumoral Calcinosis During the Course of SystemicSclerosisALEXANDRA AUDEMARD, MD; NICOLAS MARTIN SILVA, MD; JONATHAN BOUTEMY, MD; GWENOLA MAIGNÉ, MD; BORIS BIENVENU,MD, PhD, Department of Internal Medicine, Caen University Hospital, and the Faculty of Medicine, University Caen, Caen, France. Address correspondence to Dr. A. Audemard, Department of Internal Medicine, CHU Côte de Nacre, BP 95182, 14033 Caen cedex 9, France. E-mail: [email protected]. J Rheumatol 2015;42:348; doi:10.3899/jrheum.140335

Although rare, tumoral calcinosis can occur during thecourse of systemic sclerosis (SSc).A 51-year-old woman was diagnosed in 2011 with

limited cutaneous SSc, complicated by myositis. The mainclinical manifestation was extensive calcinosis at multiplelocalizations (hip, finger, back, neck), leading to signifi-cantly reduced quality of life. One year later, she com-plained of left coxalgia. Computed tomography demon-strated tumoral soft tissue calcification surrounding the lefthip joint (Figure 1). Ectopic soft tissue calcinosis is frequent(i.e., 25%) in limited SSc. Lesions are commonly located inpressure areas, most frequently in the hands. Calcinosispresumably occurs in tissues damaged by mechanical stress,hypovascularity, and tissue hypoxia1. Tumoral calcinosis

can occur during the course of SSc, but is very rare.Treatments with warfarin, colchicine, bisphosphonate,diltiazem, minocycline, and surgical excision have beenreported, but none have shown significant efficacy1,2,3.

REFERENCES 1. Boulman N, Slobodin G, Rozenbaum M, Rosner I. Calcinosis in

rheumatic diseases. Semin Arthritis Rheum 2005;34:805-12. 2. Sultan-Bichat N, Menard J, Perceau G, Staerman F, Bernard P,

Reguiaï Z. Treatment of calcinosis cutis by extracorporeal shock-wave lithotripsy. J Am Acad Dermatol 2012;66:424-9.

3. Saddic N, Miller JJ, Miller OF 3rd, Clarke JT. Surgical debridementof painful fingertip calcinosis cutis in CREST syndrome. ArchDermatol 2009;145:212-3.

Figure 1. Computed tomography demonstrated tumoral soft tissue calcification surroundingthe left hip joint.

www.jrheum.orgDownloaded on April 2, 2021 from
http://www.jrheum.org/